{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:44:48Z","timestamp":1787064288248,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Vocal fold injection medialization (VFIM) is widely used as an initial treatment for unilateral vocal fold paralysis (UVFP). Current practices employ materials that share the limitation of temporary clinical effect from variable resorption rates. A novel silk protein microparticle\u2010hyaluronic acid\u2010based material (silk\u2010HA) has demonstrated cellular infiltration and tissue deposition that may portend a durable medialization effect. We report on \u226512\u2009months outcomes after VFIM with silk\u2010HA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective open\u2010label study of patients with UVFP that elected treatment with VFIM with silk\u2010HA. Blinded experts rated laryngeal stroboscopic exams.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventeen patients with UVFP underwent VFIM with silk\u2010HA. Twelve of the 17 patients have \u226512\u2009months follow\u2010up. Seven patients demonstrated durable treatment benefit \u226512\u2009months after injection with median improvement of 19 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0156) in VHI\u201010. There was no significant change in VHI\u201010 between 1 and 12\u2009months for these patients. Blinded ratings indicated that 5\/7 patients with sustained improvements in VHI\u201010 exhibited complete or touch glottal closure at 12\u2009months. Two of the seven patients exhibited a small (&lt;1\u2009mm) glottal gap at 12\u2009months. Seven patients experienced initial benefit with later regression 3\u20134\u2009months after injection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>VFIM with silk\u2010HA can offer durable improvement in voice\u2010related outcomes for UVFP past 12\u2009months. A subset of patients treated with silk\u2010HA experienced early loss of effect around 3\u20134\u2009months postinjection. Clinical factors predictive of sustained treatment response to silk\u2010HA injection require further exploration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      3\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 134:3679\u20133685, 2024\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.31039","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T09:31:54Z","timestamp":1694079114000},"page":"3679-3685","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prospective &gt;12\u2009Months Outcomes After Vocal Fold Injection Medialization With Silk\n                    <scp>Microparticle\u2010Hyaluronic<\/scp>\n                    Acid Material"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5382-9440","authenticated-orcid":false,"given":"William Z.","family":"Gao","sequence":"first","affiliation":[{"name":"UChicago Voice Center, Department of Surgery, Section of Otolaryngology\u2013Head &amp; Neck Surgery University of Chicago  Chicago Illinois U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus F.","family":"Paoletti","sequence":"additional","affiliation":[{"name":"Keck School of Medicine of University of Southern California  Los Angeles California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1635-8627","authenticated-orcid":false,"given":"Yael","family":"Bensoussan","sequence":"additional","affiliation":[{"name":"USF Health Voice Center, Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Southern Florida  Tampa Florida U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neel K.","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Division of Laryngology, Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Washington School of Medicine  Seattle Washington U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"van der Woerd","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Otolaryngology\u2014Head &amp; Neck Surgery, McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0872-869X","authenticated-orcid":false,"given":"Elizabeth A.","family":"Shuman","sequence":"additional","affiliation":[{"name":"USC Voice Center, Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Southern California  Los Angeles California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazaneen","family":"Grant","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head &amp; Neck Surgery Georgetown University Medical Center  Washington DC U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla","family":"O'Dell","sequence":"additional","affiliation":[{"name":"USC Voice Center, Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Southern California  Los Angeles California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Michael M.","family":"Johns","sequence":"additional","affiliation":[{"name":"USC Voice Center, Department of Otolaryngology\u2013Head &amp; Neck Surgery University of Southern California  Los Angeles California U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24740"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2014.01.006"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200108000-00003"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348947308200509"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199105000-00003"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949210100307"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21666"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2005.01.009"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.03.025"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21258"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815625206"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20816"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949310200601"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2016.01.017"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2018.01.017"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27618"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e3282f033ec"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27001"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20126"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26156"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/0145561319835773"},{"key":"e_1_2_6_23_1","article-title":"Preliminary results on the safety and efficacy of silk\u2010hyaluronic acid for treatment of glottic insufficiency","author":"Dwyer CD","journal-title":"J Voice"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31039","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T16:12:13Z","timestamp":1760199133000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.31039"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,7]]},"references-count":22,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8]]}},"alternative-id":["10.1002\/lary.31039"],"URL":"https:\/\/doi.org\/10.1002\/lary.31039","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,7]]},"assertion":[{"value":"2023-04-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}